RETURN OF COMMODITIES ON WHICH LEVY IS PAYABLE FOR THE LEVY PERIOD: 1 JANUARY 2015 TO 30 JUNE 2015 (15A). DUE DATE: 31 JULY 2015.

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1 ETUN OF COMMODITIES ON WHICH LEVY IS PAYABLE FO THE LEVY PEIOD: 1 JANUAY 2015 TO 30 JUNE 2015 (15A). DUE DATE: 31 JULY Urgent Attention : Financial / Imports/Shipping Manager Manufacturer/ Importer name Postal address HEF no JDE no For enquiries regarding this return : Tel No s : Postal code Deposit reference (please use HEF no) Fax No: In the interest of public health and safety the Minister of Trade and Industry has introduced compulsory specifications for a number of commodities. The NCS administers these specifications on behalf of the Minister and also collects the levies payable in respect of the commodities concerned, as prescribed in the NCS Act No. 5 of 2008, Section 14(3)(b). Please visit our website THE COMPLETED ETUN TOGETHE WITH YOU POOF OF PAYMENT FO THE APPLICABLE LEVY DUE MUST EACH THE NCS ON O BEFOE 31 JULY AN INVOICE CAN ONLY BE POCESSED ONCE YOU COMPLETED LEVY ETUN HAS BEEN ECEIVED. NB: PLEASE COMPLETE AND ETUN THIS FOM AS A UNIT! NB: CHEQUE AND CASH PAYMENTS AE NOT ACCEPTED. 1. The levy payable must be calculated as follows: TOTAL QUANTITY MANUFACTUED AND/O IMPOTED X TAIFF AS INDICATED. (PLEASE NOTE: Quantities are based on manufacture and/or importation and NOT ON SALES. Also note that levy tariffs increase annually as promulgated in Government Gazette.) 2. The return must be completed and signed by a duly authorized signatory. 3. Any manufacturer* or importer to whom this form is addressed, is obliged by regulation to COMPLETE AND ETUN it to the NCS, also in the event of a NIL manufacture or import. These forms are sent bi-annually. 4. If a manufacturer* or importer fails to submit the return, the NCS may calculate the levy payable on the manufacture or importation of a commodity and hold the manufacturer* or importer liable for the levy so calculated; provided that the payment of a levy on the basis of an estimate shall not absolve the manufacturer* or importer from settling in full any additional amount that may be due to the NCS. 5. NON-SUBMISSION of the COMPLETED return, regardless of payment already paid into the NCS bank account, may result into an administration fee being added to your account with us. * The definition of manufacture according to the NCS Act includes produce, assemble, alter, modify, adapt, convert, process or treat. PLEASE COMPLETE: I, (Initials and Surname) a) acknowledge that I am duly authorized to submit this return on behalf of the above-mentioned manufacturer or importer; and b) confirm that the particulars furnished herein are true and correct in every respect for which the amount of. is due. NB: FO FINAL CALCULATIONS AND BANKING DETAILS OF THE NCS, PLEASE POCEED TO THE LAST PAGE OF THIS ETUN. SIGNATUE CAPACITY CELL NUMBE DATE To ensure the correctness of NCS records you are requested to supply the following information. TEL NO: FAX NO: (ACCOUNTS): Street Address Postal Address (if different from the above) AA53/ /06/01 nrcs.pta

2 BU January to 30 June 2015 (A) LIGHTES FO CIGAETTES, CIGAS AND PIPES Page 2 of 6.. Code Description of commodity 4510 Disposable lighters (for cigarettes, cigars and pipes) (VC 8076) 100 Lighters 4511 efillable lighters (for cigarettes, cigars and pipes) (VC 8076) 100 Lighters 3,00 3,00 Code Description of commodity FOOTWEA 4600 Safety Footwear (VC 9002) 1 Pair 0,30 Code Description of commodity BIOLOGICAL SAFETY CABINETS 5310 Microbiological safety cabinets (Classes I, II and III) (VC 8041) Item 4 438,00 Code Description of commodity COAL / PAAFFIN-BUNING APPLIANCES 8110 Coal-burning stoves and heaters (VC 8034) Item 142, Non-pressure paraffin stoves and heaters (VC 9089) Item 2, Pressurized paraffin fuelled appliances (VC 9093) Item 2,59 AA /06/01 nrcs.pta

3 Page 3 of 6.. BU January to 30 June 2015 (A) FIE-AMS Code Description of commodity im fire arms (VC 8028) Item 11, evolvers (VC 8028) Item 17, Centre fire rifles and pistols (VC 8028) Item 17, Double-barrel shotguns (VC 8028) Item 17, Single-barrel shotguns (VC 8028) Item 14, All types of replacement barrels (VC 8028) Item 11, Modified rim- and center fire rifles, revolvers and pistols (VC 8028) Item 22, Modified double-barrel shotguns (VC 8028) Item 22, Modified single-barrel shotguns (VC 8028) Item 20,50 Code Description of commodity TIMBE 4710 Preservative Treated Timber (VC 9092) Per 1 m³ Code Description of commodity CEMENT 8400 Cement (VC 9085) Per Metric Ton 1,11 0,19 DISINFECTANTS & DETEGENTS NB : QUANTITY TO BE OUNDED OFF TO THE NEXT FULL UNIT!! Code Description of commodities 8700 Disinfectants and Detergent-disinfectants (VC 8054) 100 liters or 100 kg 6,15 AA /06/01 nrcs.pta

4 BU January to 30 June 2015 (A) Page 4 of 6.. Code Description of commodities PESONAL POTECTIVE EQUIPMENT 8280 Gas filters and combined filters (SANS 54387) (VC 8072) Item 0, Filters for connection by means of breathing hoses to face pieces Item 0,34 (SANS 275 ) (VC 8072) 8281 Full-face masks (SANS 50136) (VC 8072) Item 10, Half masks and quarter masks (SANS 50140) (VC 8072) Item 1, Filtering half masks to protect against particles Item 0,11 (SANS 50149) (VC 8072) Valve filtering half masks to protect against gases or gases and Item 6,81 particles (SANS 50405) (VC 8032) 8284 Half mask without inhalation valves and with separable filters to protect against gases or gases and particles or particles only Item 1,25 (SANS 51287) (VC 8072) 8285 Particle filters (SANS 50143) (VC 8072) Item 0, Powered filtering devices incorporating a helmet or a hood (SANS 12941) (VC 8072) Power assisted filtering devices incorporating full face masks, half masks or quarter masks (SANS 12942) (VC 8072) 8291 Compressed air line breathing apparatus for use with demand valve for use with a full face mask (SANS ) (VC 8072) Continuous flow compressed air line breathing apparatus (SANS 54594) (VC 8072) Compressed air line breathing apparatus with demand valve for with a half mask at positive pressure(sans ) (VC 8072) 8292 Fresh air hose breathing apparatus for use with full face mask, half mask or mouthpiece assembly (SANS 50138) (VC 8072) Powered fresh air hose breathing apparatus incorporating a hood (SANS 50269) (VC 8072) 8293 Self-contained closed-circuit breathing apparatus of the compressed oxygen or compressed oxygen-nitrogen type (SANS 50145) (VC 8072) 8294 Self-contained open-circuit compressed air breathing apparatus (SANS 50137) (VC 8072) 8295 Self-contained closed-circuit breathing apparatus for escape apparatus (SANS 53794) (VC 8072) Self-contained open-circuit compressed air breathing apparatus with full face mask or mouthpiece assembly for escape (SANS 50402) (VC 8032) Filtering devices with hood for self-rescue from fire (SANS 50403) (VC 8032) Filter self-rescuers for protection against carbon monoxide (SANS 50404) (VC 8032) Compressed air escape apparatus with a hood (SANS 51146) (VC 8032) Item 110,55 Item 110,55 Item 1040,00 Item 152,59 Item 136,14 Item 209,44 Item 28,43 Item 14,22 Item 178,19 AA /06/01 nrcs.pta

5 BU January to 30 June 2015 (A) Page 5 of 6 Code Description of commodities 4310 Swimming aids that are carried or worn on the body (SANS ) SWIMMING AIDS / LIFE JACKETS Item 0, Swim seats (SANS ) Item 0, Buoyancy aids (level 50) (SANS ) Item 6, Special purpose buoyancy aids (SANS ) Item 6, Lifejackets for inland / close to shore conditions (level 100) Item 13,71 (SANS ) Lifejackets for offshore conditions (level 150) Item 13,71 (SANS ) Lifejackets for extreme offshore conditions (level 275) (SANS ) Item 13, Lifejackets for seagoing ships (SANS ) Item 13, Special Purpose lifejackets (SANS ) Item 13,71 SAFETY GLASS / GLAZING MATEIALS Code Description of commodities 4400 Safety glass and other safety glazing material (VC 9003) Per 1 m 2 0,20 Please note: Should you require technical advice or any other information regarding these commodities, please contact Simon Odendaal at Tel AA /06/01 nrcs.pta.

6 BU January to 30 June 2015 (A) N. CALCULATION TABLE & BANKING DETAILS Page 6 of 6 TOTAL LEVY DUE PLUS DEBIT (IF ANY) BOUGHT FOWAD LESS CEDIT (IF ANY ) BOUGHT FOWAD PAYMENT ENCLOSED PLEASE DO NOT ADD VAT! IMPOTANT NOTES: The NCS is not VAT registered / (VAT exempted). All invoice amounts are exclusive of VAT. The NCS does not have a company registration number due to it being a Section 3(a) public entity. BANKING DETAILS FO NCS LEVY PAYMENTS: PAYABLE TO : NCS (NATIONAL EGULATO FO COMPULSOY SPECIFICATIONS) BANK : ABSA ACCOUNT NO : BANCH : BOOKLYN BANCH CODE : or ( ) METHOD OF PAYMENT: Direct deposit or Electronic Transfer (EFT): Always quote your JDE Account Number or HEF reference number which appears on the front page of this return. NB: Cheque or Cash payment will not be accepted in future. SUBMISSION: E- Mail, Fax or Mail the completed return for the attention of the contact person mentioned below. *Non-submission of this completed levy return, regardless of payment to the NCS bank account, may result in an administration fee of being charged to your levy account. All of the completed pages i.r.o. this return must be returned to the NCS! CONTACT PESON : MAGDA SPIES FAX TO * : TEL NO : ADDESS : magda.spies@nrcs.org.za POSTAL ADDESS : NCS PIVATE BAG X25 BOOKLYN 0075 AA /06/01 nrcs.pta